Ikegami Masako, Wang Zijian
Department of Innovation Science, School of Environment and Society, Tokyo Institute of Technology, Tokyo, Japan.
Center for Pacific Asia Studies, Uppsala, Sweden.
Qual Quant. 2023;57(2):1657-1672. doi: 10.1007/s11135-022-01412-x. Epub 2022 Jun 8.
The trade-off between military expenditure and public health spending has remained an unsettled empirical issue. This paper investigates whether military expenditure has crowded out public health spending in 116 countries (including a subsample of 87 non-OECD countries) over the period 2000-2017. Through our system generalized methods of moments (GMM) estimations, we find that military expenditure, whether it is measured on a per-capita basis or as a proportion of total government expenditure, has a positive impact on the demand for health care. Nonetheless, we find a significant crowding-out effect of military expenditure on domestic government health spending by taking into account government fiscal capacity. The evidence we present supports the long-standing view that military expenditure has a particular ability to compete government financial resources away from publicly funded health spending. By interacting the military expenditure variable with income per capita, we find that an increase in income per capita has neutralized the crowding-out effect of military expenditure on domestic government health spending - less well-off countries stand to suffer most, and wealthy ones stand to suffer least, from the crowding-out effect. The crowding-out effect is statistically more specific to middle- and low-income countries in our samples.
军事支出与公共卫生支出之间的权衡一直是一个尚未解决的实证问题。本文研究了在2000年至2017年期间，116个国家（包括87个非经合组织国家的子样本）的军事支出是否挤出了公共卫生支出。通过我们的系统广义矩估计（GMM），我们发现，无论军事支出是按人均计算还是作为政府总支出的比例来衡量，它对医疗保健需求都有积极影响。尽管如此，考虑到政府财政能力，我们发现军事支出对国内政府卫生支出有显著的挤出效应。我们提供的证据支持了长期以来的观点，即军事支出具有将政府财政资源从公共资助的卫生支出中竞争走的特殊能力。通过将军事支出变量与人均收入进行交互，我们发现人均收入的增加抵消了军事支出对国内政府卫生支出的挤出效应——在挤出效应方面，较不富裕的国家受影响最大，而富裕国家受影响最小。在我们的样本中，挤出效应在统计上对中低收入国家更为显著。
